A blood gas that resists a quick label

An ICU arterial result has pH 7.28, PaCO2 60 mmHg, and calculated HCO3 27 mmol/L. The adult arterial teaching intervals are pH 7.35 to 7.45, PaCO2 35 to 45 mmHg, and HCO3 22 to 26 mmol/L. Interpret this released result in a defensible sequence rather than treating it.

The specimen was collected in a heparinized syringe without a visible air bubble and analyzed within 10 minutes. pH and PaCO2 are measured on the blood gas analyzer, while HCO3 and base excess are calculated. Method basis and specimen condition belong beside the result before physiology is inferred.

The low pH establishes acidemia, but it does not establish compensation or a diagnosis. Anion gap and lactate intervals vary by method and specimen source, so local intervals are required. Record specimen type, method basis, flags, and local intervals before using the worksheet.